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Prescription Drug Reimbursement

If for some reason you paid the full cost of a covered prescription, you can ask us to reimburse you for the difference between your copay or coinsurance and the total cost of the medication. Instances where this may happen include but are not limited to:

  • The covered drug/product you needed is not usually stocked at a network retail (local) or home delivery pharmacy service.
  • You become sick or you run out of your medication when traveling outside of Braven Health's service area.
  • You couldn't choose a network pharmacy because you received the covered drug while in an Emergency Room, medical clinic or other outpatient facility.

Submit a reimbursement form with an itemized receipt and a copy of your member ID card to the address below:

Medicare Claims
PO Box 20970
Lehigh Valley, PA 18002-0970

pdf imageMedicare Rx Claim Form

pdf imageMedicare Rx Claim Form - Spanish

Please note: Prescription drug claims are managed by Prime Therapeutics, Braven Health's pharmacy benefits manager.